Re: Fasting glucose and Insulin stress test

[Guest guest]

Hi Tess,

No probably not worth you passing on the endos name, with luck she won't be

practising for much longer.... we should boycott all the idiotic ones.

If you are in need of insulin as in not making it, or you need extra then the

weight will stay on apparantly...

May as well just get in there and google it, you know you will in the end.

Rather have it in one lump so you can work out what to do, than get it fed to

you in dribs and draps from the docs, endos and imcompetants.

You wouldn't go on about your weight if they'd sorted out your meds properly,

just ignore the endo comments. It makes them feel good if they can make your

opinions look less valid than their own

xx

>

> Hi folks,

>

> Just back from GP, ( she's not best pleased at endo's letter either) she'd

asked to see me because physio had written to her about my shoulder pain - the

painkillers don't help my constipation so wasn't taking them so physio wanted me

to start steroid injections again.

[Guest guest]

Yes please Tess.

Luv - Sheila

Oh and on her letter from endo....same as mine but endoprat had added " I

wouldn't rule out this patient over medicating because she is not hyperthyroid

anymore and consistently talks about her weight " ......words to that

effect!!! Duh...T4 of 9 (9-21) and T3 1.? ....... suppose I should be grateful

that words like ' over anxious, nervous, depressed ' weren't added!!!

Do you want endo's name for your list Sheila? She's good at rendering me

SPEECHLESS!!!

Love Tess x

[Guest guest]

Thank you :-)

Still not googled but you're right...I will in the end... My Mum's Diabetic and

said she got the fasting glucose but has never heard of the stress test.....and

off course she's

always right so I must have picked doc up wrong lol....

Love Tess xx

>

> Hi Tess,

>

> No probably not worth you passing on the endos name, with luck she won't be

practising for much longer.... we should boycott all the idiotic ones.

>

> If you are in need of insulin as in not making it, or you need extra then the

weight will stay on apparantly...

>

[Guest guest]

Did your mother say there's no such test? or were you joking? Sorry wasn't

quite sure!? perhaps it was insulin tolerance test. can you find out what the

test is for? maybe a glucagon stimulation test would be better?

chris

http://en.wikipedia.org/wiki/Insulin_tolerance_test

Insulin tolerance testFrom Wikipedia, the free encyclopediaJump to: navigation,

search

An insulin tolerance test (ITT) is a medical diagnostic procedure during which

insulin is injected into a patient's vein to assess pituitary function, adrenal

function, and sometimes for other purposes. An ITT is usually ordered and

interpreted by endocrinologists.

Insulin injections are intended to induce hypoglycemia. In response,

Adrenocorticotropic hormone (ACTH) and Growth Hormone (GH) are released as a

part of the stress mechanism. ACTH elevation causes the adrenal cortex to

release cortisol. Normally, both cortisol and GH serve as Counterregulatory

hormones, opposing the action of insulin, i.e. acting against the

hypoglycemia.[1]

Thus ITT is considered to be a Gold standard for assessing the integrity of the

hypothalamo-pituitary-adrenal axis. Sometimes ITT is performed to assess the

peak adrenal capacity, e.g. before surgery. It is assumed that the ability to

respond to insulin induced hypoglycemia translates into appropriate cortisol

rise in the stressful event of acute illness or major surgery.[2]

This test is potentially very dangerous and must be undertaken with great care.

A health professional must attend it at all times.

Contents [hide]

1 Side Effects

2 Contraindications

3 Interpretation

3.1 Hypopituitarism

3.2 Cushing's syndrome

4 See also

5 References

[edit] Side EffectsSide effects include sweating, palpitations, loss of

consciousness and rarely convulsions due to severe hypoglycemia which may cause

coma. If extreme symptoms are present, glucose should be given intravenously. In

subjects with no adrenal reserve an ian crisis may occur. For cortisol

stimulation, the ACTH stimulation test has much less risk

[edit] ContraindicationsThis test should not be performed on children outside a

specialist pediatric endocrine unit

Ischemic heart disease

Epilepsy

Severe panhypopituitarism, hypoadrenalism

Hypothyroidism impairs the GH and cortisol response. Patients should have

corticosteroid replacement commenced prior to thyroxine as the latter has been

reported to precipitate an ian crisis with dual deficiency. If adrenal

insufficiency is confirmed, the need for a repeat ITT may need to be

reconsidered after 3 months thyroxine therapy.

[edit] InterpretationThe test cannot be interpreted unless hypoglycaemia (< 2.2

mmol/L (or) < 40 mg/dl) is achieved.

[edit] HypopituitarismAn adequate cortisol response is defined as a rise to

greater than 550 nmol/L. Patients with impaired cortisol responses (less than

550 but greater than 400 nmol/L) may only need steroid cover for major illnesses

or stresses. An adequate GH response occurs with an absolute response exceeding

20 mU/L.

[edit] Cushing's syndromeThere will be a rise of less than 170 nmol/L above the

fluctuations of basal levels of cortisol.

[edit] See alsoACTH stimulation test

hypopituitarism

triple bolus test

>

> Thank you :-)

>

> Still not googled but you're right...I will in the end... My Mum's Diabetic

and said she got the fasting glucose but has never heard of the stress

test.....and off course she's

> always right so I must have picked doc up wrong lol....

>

> Love Tess xx

[Guest guest]

Hi

I was half joking :-) she said fasting glucose for diabetes, she has diabetes

but because she had never had or heard of insulin stress test....in her head...I

picked it up wrong :-)

GP wrote insulin stress test on a post it for me but I just googled when I read

your post.....your link came up so must be same test but different names for it?

I'm getting it for something to do with pituitary and my lack of TSH despite

bottom range T4 & 3 but GP said I need to do the fasting glucose first...the

results of that will determine whether or not they can do the insulin test?

Don't know why but I've googled now so would be as well reading it. Have you had

this one done before?

Thanks for link :-)

Love Tess

>

> Did your mother say there's no such test? or were you joking? Sorry wasn't

quite sure!? perhaps it was insulin tolerance test. can you find out what the

test is for? maybe a glucagon stimulation test would be better?

>

> chris

>

>

[Guest guest]

Hi Tess

i thought that's what you meant - 'that you must have misheard' - but wasn't

sure :-)

i've not had the test done, no, but i have heard of it. i think the idea is the

insulin lowers your blood sugar to a point where you body thinks its an

emergency and triggers hormones - if able - to get the blood sugar back up. i

would have a good read up on it so you know what to expect

chris

>

> Hi

>

> I was half joking :-) she said fasting glucose for diabetes, she has diabetes

but because she had never had or heard of insulin stress test....in her head...I

picked it up wrong :-)

> GP wrote insulin stress test on a post it for me but I just googled when I

read your post.....your link came up so must be same test but different names

for it?

[Guest guest]

Hiya

ooft...dunno if I'm up for that! It looks scary lol, just had a good google and

I'm surmising if the fasting glucose came back low - I wouldn't get the stress

test- do you think that's what GP meant when she said it depends on glucose

results whether I'd be able to get the other one?

I looked up symptoms of high glucose.....symptoms I get ( on exertion) are more

low

blood sugar so I dug out copies of blood results - the two high glucose results

were

when I was Hyper!! Good old google again - seems that's a hyper symptom - that's

one I never knew. I'm definitely a bit wary of that test - glucose one not till

next Fri though.

Are you any further forward after your phone call with doctor?

Love Tess

>

> Hi Tess

>

> i thought that's what you meant - 'that you must have misheard' - but wasn't

sure :-)

>

> i've not had the test done, no, but i have heard of it. i think the idea is

the insulin lowers your blood sugar to a point where you body thinks its an

emergency and triggers hormones - if able - to get the blood sugar back up. i

would have a >